Claims associate vs claims administrator

The differences between claims associates and claims administrators can be seen in a few details. Each job has different responsibilities and duties. It typically takes 2-4 years to become both a claims associate and a claims administrator. Additionally, a claims associate has an average salary of $36,558, which is higher than the $36,432 average annual salary of a claims administrator.

The top three skills for a claims associate include customer service, medical claims and phone calls. The most important skills for a claims administrator are data entry, customer service, and process claims.

Claims associate vs claims administrator overview

	Claims Associate	Claims Administrator
Yearly salary	$36,558	$36,432
Hourly rate	$17.58	$17.52
Growth rate	-3%	-3%
Number of jobs	9,145	59,006
Job satisfaction	-	4
Most common degree	Bachelor's Degree, 48%	Bachelor's Degree, 53%
Average age	44	44
Years of experience	4	4

What does a claims associate do?

Claims associates control claims for insurance companies. Their job duties include determining a customer's insurance coverage and evaluating those who have filed a claim. Also, they must make sure that a claim is analyzed correctly for the clients to receive their entitled financial settlement. The work may require the agent to travel to generate information about the claim and may vary from a different position in the insurance industry. Qualifications for the job include an associate degree, excellent interpersonal and research skills as well as relevant experience in customer service.

What does a claims administrator do?

Claims administrators are professionals who are responsible for performing administrative duties related to insurance claims. These administrators must collaborate with insurance companies so that they can analyze claims and determine the extent of the company's liability. They must review billing and process claims correctly by identifying provider information and other documentation to ensure a prompt payout. Claims administrators must also maintain and manage the compensation files of all workers in order to conduct preliminary investigations on work-related injuries for worker's compensation claims.

Claims associate vs claims administrator salary

Claims associates and claims administrators have different pay scales, as shown below.

	Claims Associate	Claims Administrator
Average salary	$36,558	$36,432
Salary range	Between $30,000 And $44,000	Between $29,000 And $44,000
Highest paying City	Hartford, CT	Reno, NV
Highest paying state	Connecticut	Connecticut
Best paying company	Accenture	ABB
Best paying industry	Insurance	Hospitality

Differences between claims associate and claims administrator education

There are a few differences between a claims associate and a claims administrator in terms of educational background:

	Claims Associate	Claims Administrator
Most common degree	Bachelor's Degree, 48%	Bachelor's Degree, 53%
Most common major	Business	Business
Most common college	-	-

Claims associate vs claims administrator demographics

Here are the differences between claims associates' and claims administrators' demographics:

	Claims Associate	Claims Administrator
Average age	44	44
Gender ratio	Male, 30.3% Female, 69.7%	Male, 28.9% Female, 71.1%
Race ratio	Black or African American, 13.8% Unknown, 4.3% Hispanic or Latino, 14.4% Asian, 3.9% White, 63.2% American Indian and Alaska Native, 0.5%	Black or African American, 13.8% Unknown, 4.3% Hispanic or Latino, 14.4% Asian, 3.9% White, 63.2% American Indian and Alaska Native, 0.5%
LGBT Percentage	11%	11%

Differences between claims associate and claims administrator duties and responsibilities

Claims associate example responsibilities.

Investigate, evaluate, and manage call to complete coverage analysis confirming or denying coverage using Xactimate estimating software.
Obtain vehicle information from the DMV.
Follow HIPAA policy on each and every call.
Abided by the laws and regulations associate under HIPAA and patient confidentiality.
Receive recognition for creating a workflow and database for all incoming subpoenas.
Assist in training new CSA s on job responsibilities, which increase office productivity.

Claims administrator example responsibilities.

Manage adding and removing vendors through claims automate system to ensure they are in compliance with IRS regulations.
Implement HIPAA regulations to protect patient privacy.
Adjudicate medical, commercial and Medicaid, claims.
Code medical records by following current ICD-9/ICD-10, CPT, and HCPCS standards.
Work with doctors, TPA, adjusters, attorneys, to maintain claim cost effectively.
Process various compensation benefits applications for veterans in compliance with organizational laws, federal laws, rules and regulations.

Claims associate vs claims administrator skills

Common claims associate skills

Customer Service, 14%
Medical Claims, 8%
Phone Calls, 8%
Claims Handling, 7%
Insurance Claims, 6%
Medical Terminology, 5%

Common claims administrator skills

Data Entry, 12%
Customer Service, 9%
Process Claims, 8%
Phone Calls, 7%
HR, 5%
Insurance Claims, 5%

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Office and Administrative Industry
Claims Associate
Claims Associate vs Claims Administrator

Updated January 8, 2025

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